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March 2003
Peace As Preventive Medicine

The Satya Interview with Dr. Victor Sidel



Dr. Victor Sidel is a New York-based physician who co-founded Physicians for Social Responsibility (PSR) in 1961. He is also a former co-president of International Physicians for the Prevention of Nuclear War (IPPNW).

At the height of the Cold War, with the world poised on the brink of nuclear war, a small group of Soviet and American doctors decided to establish a federation—IPPNW. They reasoned that their common interest in survival was more powerful than the political or ideological divides between them; and believed that their obligation as physicians included a common commitment to the prevention of nuclear war.

IPPNW hit the map over a decade ago by sounding the alarm from the healthcare community on the potential health and environmental devastation that would result from the use of nuclear weapons. Drawing upon data from the effects of the bombs dropped on Hiroshima and Nagasaki, combined with medical knowledge of burn, blast, and radiation injuries, IPPNW concluded that nuclear war “would be the final epidemic; that there would be no cure and no meaningful medical response.” This chilled the hearts of millions, causing policy-makers to sit up and take notice. For its work in raising awareness, IPPNW, along with its affiliates around the world, including PSR in the U.S., was awarded the Nobel Peace Prize in 1985.

IPPNW continues to raise awareness on the health effects of war. Dr. Sidel served as an advisor for “Collateral Damage: the Health and Environmental Costs of War on Iraq,” an eye-opening report released in December by Medact, the IPPNW UK affiliate. The report analyzes the existent evidence on the aftereffects of the Gulf War, and, based on this, predicts that between 28,000 and 260,000 Iraqis will die in the first three months of a war.

Dr. Sidel took a moment from his busy schedule to talk with Catherine Clyne about IPPNW and the real threat that nuclear weapons pose with the U.S. on the brink of war.

For those of our readers who have never heard of IPPNW, how would you describe it?
The International Physicians for the Prevention of Nuclear War was founded at a point when a number of groups of physicians and other health workers around the world were working on the prevention of nuclear war. In 1980, two cardiologists, Dr. Bernard Lown in the U.S., and Dr. Evgueni Chazov in the Soviet Union, gathered together groups of people—largely physicians—to form an international federation called IPPNW.

At the moment, IPPNW has one affiliate group in each of 58 different countries. In the U.S. the group is Physicians for Social Responsibility, which has been a key affiliate of IPPNW since its founding.

Over the past year, with the threat of war being made in Iraq, IPPNW and all of its affiliates have taken a very strong position against the war. They have placed advertisements, written letters. The IPPNW affiliate in the UK has remonstrated with Prime Minister Blair with regard to his support of the U.S. In France and Germany, where there are very strong IPPNW affiliates, they have supported the government; the Canadian affiliate—again, very strong—has urged the government not to support the U.S., and that appears to have had some effect; and so on around the world.

Why physicians specifically? Why should the prevention of war be of particular importance to physicians?
The reasoning was that it is physicians and other health workers who will have to treat casualties if a nuclear attack occurs, they would have some weight on the topic. Indeed, it was particularly because physicians were taking that position, that the work of IPPNW and its affiliates was recognized by the Nobel Prize Committee in 1985.

How did this movement evolve?
The first project started by PSR in 1961 was an analysis of the medical consequences of a thermonuclear bomb dropped on a city. Nuclear bombs, of course, had already been dropped in 1945 on Hiroshima and Nagasaki, but those were relatively small. During the 1950s, first the U.S. and then the Soviet Union developed hydrogen bombs—thermonuclear bombs—which have a potential yield one thousand-fold greater than the bombs dropped on Hiroshima and Nagasaki.

One thousand times greater?
Yes. To be precise, the bombs dropped on Hiroshima and Nagasaki were on the order of 15 kilotons—15,000 tons—of TNT equivalent. The bombs that were made during the 1950s were one thousand-fold, which means they were not in the kiloton range, but in the megaton range in terms of TNT equivalent.

So, from what was available in the open literature, a group of physicians in Boston analyzed the consequences if one of those new bombs was used: in terms of blast—the explosive force; in terms of heat—the production of fires; and, of course, the radiation. After doing this extensive analysis, a series of articles were published in the New England Journal of Medicine (one of the premiere medical journals in the U.S.) in 1962. We said that there was virtually nothing that medical professionals could do after the fact; and therefore that medical physicians and professionals had a responsibility to work for the prevention of nuclear war. And the then-editor of the NEJM wrote an editorial supporting what we were saying. That was the beginning of PSR, which eventually led to the formation of the international umbrella group—IPPNW.

As a physician who has dedicated his life to stopping war and the potential use of nuclear weapons, what’s going through your mind right now—since we’re so close to going to war?
Several concerns, obviously, are going through my mind. The first, covered in “Collateral Damage,” is the way in which the Iraqi people have suffered in terms of health, since 1991; and what would happen if there were another attack now on those weakened people. The other concern is that nuclear weapons might be used. This stems from a couple of things: one is that the U.S. government has talked about the development of “bunker buster” bombs—modifying nuclear weapons into what are technically called “earth penetrating weapons.” The idea that the U.S. is ready to use such a nuclear bomb strongly weakens the prohibition against the use of nuclear weapons that has been followed since 1945.

In “Collateral Damage,” some of the predictions have very wide ranges. How useful are such numbers if we don’t even have accurate information on the actual body counts from the Gulf War?
I think that’s a very good question. Similar reports, published by the United Nations and a couple of groups that have recently gone to Iraq, have refrained from giving estimates of the number of casualties that would occur in an attack on Iraq. I think that “Collateral Damage” put in those estimates to give some idea of the magnitude that could occur. And you’re right—the report clearly says that there’s no way of knowing what the nature of the attack will be, or even whether the attack will occur, but that if it does, here is a wide range of estimates of how bad it could be.

There have been some newspaper reports, from leaks and whatever from the U.S. government, about the use of bombs to produce “shock” and “awe,” which suggests a truly massive initial attack—indeed—in order to try to shock the Iraqi military forces and the Iraqi people into offering no resistance.

What have we learned from Hiroshima and Nagasaki about the consequences of urban bombing? And what does that tell us about a possible invasion of Baghdad?
Actually, the issue of urban bombing really began in earnest in 1937 with the German bombing of the Spanish city of Guernica. That was of course memorialized in the incredible painting by Pablo Picasso. As an aside: a tapestry of that painting was donated by Nelson Rockefeller to the UN and is on the wall outside the Security Council chamber. It was covered over during the Colin Powell report to the Security Council on February 5th.

Just during the report?
It was covered just before the report, and now has been uncovered again. The UN sources say they did that because the television cameras needed a clear background, but of course many of us suspect that it was not permitted to be seen because it indicated what the nature of a bombing of civilian targets would produce.

Anyway, the point is, the bombing of Guernica was a clear attempt to intimidate; the bombers by-passed potential military targets in order to bomb the city where civilians lived. That led to a whole series of attacks on civilians during the war—first by the Germans on Warsaw, Rotterdam, London, Coventry, and other cities; and then a response by the Allies with bombings of Dresden, Hamburg and other German cities. Fire-bombings of cities in Japan were conducted on Tokyo and Osaka. Hiroshima and Nagasaki were spared because it is alleged the U.S. wanted to leave them as test sites for the nuclear bombs. But it does not require a nuclear bomb to produce that kind of devastation.

How different is the explosion of one nuclear bomb in comparison to “conventional” fire-bombing?
The deaths in Hiroshima and Nagasaki were on the order of 100,000 people in each city—both immediate deaths and deaths within the next few weeks. Bombing raids of a number of different cities in WWII produced death tolls of about 100,000 people or more, but that was produced by wave upon wave of continued bombing over the space of several days or weeks. You can produce equivalent damage using so-called conventional weapons (not nuclear), it just takes a little longer.

In the eighties, the anti-nuclear movement was very prominent. It seems momentum has died down since. How real do you think is the possibility of the use of nukes now as opposed to then?
In the 1980s with Ronald Reagan in the White House, the concern was the use of nuclear weapons by the U.S.—there was also some potential threat of use by other countries, although I don’t think anybody really believed that was going to happen. On the other hand, the U.S. was brandishing its nuclear weapons. That seemed to end or at least die down with the disappearance of Mr. Reagan from the White House. And then it resurfaced at the end of the Clinton administration, when the U.S. nuclear posture review confirmed that the U.S. would use nuclear weapons in response to other “weapons of mass destruction.” And now with Mr. Bush in the White House, the threat has been magnified. That has reawakened, reenergized the anti-nuclear war people throughout the world, including those affiliated with IPPNW.

When Americans are trying to figure out for themselves whether or not they feel we should attack Iraq, what do you think are the most important things they should know? And are they being represented sufficiently by our media?
I’ll answer the last part first. I think they’re insufficiently represented by the media. Of course, there’s been a bit of a change, following the rallies around the world on February 15th—the press has indeed taken note of that. But in general, the press has incompletely reported on the vehemence of the feelings of people around the world against an attack on Iraq. I think the reasons for that are multiple. One is, as “Collateral Damage” and other reports indicate, the civilian casualties that will occur from such an attack. But in some ways even more important are two long-term consequences. One, is the result of an attack may increase the danger to the U.S. and other countries of what has been called terrorism; and second, is the way it isolates the U.S. from other countries in the world, and weakens the UN in the process.

Aside from Iraq, what do you feel are the most dangerous scenarios or areas in the world for the potential use of nuclear weapons?
As we’ve said, one area of terrible danger is the U.S., which obviously has the world’s largest nuclear arsenal and may be tempted to use them in one way or another in the event of a war. Another is the increasing proliferation of these weapons to countries around the world. It used to be a rather small “nuclear club,” but the number of countries that have been added to it has increased, including Israel, and Pakistan and India, and now possibly North Korea, which may have one or two nuclear weapons, and possibly other nations. The danger of nuclear war has existed since 1945, but we’re reaching the point where the danger may be considerably greater.

In the face of all this, what gives you hope?
The fact that literally millions of people came out to demonstrate on February 15th provides some hope. But on the other hand, against that is the 250,000-plus troops that the U.S. has sent to the borders of Iraq. And the question is how those can be pulled back without the loss of face by Mr. Bush. At the moment I think that represents the most important danger—that is, once the troops are there, even though virtually the entire world is against it, he may be forced to use them because they’re there.

To learn more about IPPNW or to read “Collateral Damage: the Health and Environmental Costs of War on Iraq,” visit or call (617) 868-5050. For information about PSR see or call (202) 667-4260.


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